It is said, youths are the future leaders of tomorrow; but I fear for the future of Cameroonian youths, especially adolescent girls in my community. This essay addresses adolescent/teenage pregnancies, spotlighting the situation of a rural community in Cameroon. Varying definitions have been attributed to adolescent or teenage pregnancy, but it generally refers to pregnancy in a girl who has not attained adulthood; regardless of her marital status.
In Cameroon, adults are referred to individuals aged 21 years and above. According to the United Nations Children Fund (UNICEF), adolescent pregnancy is pregnancy occurring in a girl aged 13 – 19 years.
Adolescent pregnancy is a major public health concern worldwide, particularly in sub-Saharan Africa. In fact, according to the World Health Organisation (WHO), the complications of adolescent pregnancy and child birth are the second cause of death in girls aged 15 – 19 years worldwide (WHO; fact sheet 2014).
Globally, 11% of all births result from adolescent pregnancies, with 95% of these births occurring in low and middle income countries (WHO; fact sheet 2014). Pregnancy in adolescence is associated with higher risk of caesarean deliveries, low infant birth weight, neonatal asphyxia and prematurity; consequently increasing maternal and infant morbidity and mortality.
Practices such as sociocultural norms that encourage early marriages, poor knowledge on reproductive sexual health, myths and misconceptions about contraceptives, poverty and low self-esteem have been attributed to adolescent pregnancy (UNICEF; fact sheet 2008).
The situation of adolescent pregnancy in Cameroon like in other sub-Sahara African countries is disturbing. Contrasting prevalences of adolescent pregnancy have been reported throughout the national territory ranging from 2.8 – 26.5%; with a national prevalence of 14.2%. Most of these studies were focused on urban and sub-urban areas. Availability of information on adolescent pregnancies in rural areas in Cameroon are sparse; meanwhile, these are the areas with the most vulnerable adolescents.
The Oku community located in the Bui Division is made up of about 130,000 inhabitants composing principally of the Oku and the Fulani tribes. The topography is mountainous with most of the inhabitants living below the poverty limit of 600 FCFA per day, and having as main occupations: farming, hunting and cattle rearing. The Oku Health District is found within the Oku community, made of 10 Health Areas, with only four medical doctors responsible for the health of the entire community.
This essay seeks to illuminate the factors associated with a seemingly increasing rate of adolescent pregnancy, the outcome of teenage mothers and their children in the aforementioned community, and to propose a way forward.
Adolescent pregnancies are not uncommon in this part of the country and it poses a threat to the future of the youths, infant and maternal health. A couple of reasons could explain the high rate of adolescent pregnancy in this part of the country including: encouragement of early marriages, poverty, lack of proper education on sexual and reproductive health, decrease awareness and wrong use of contraceptive methods, and low educational ambition.
Lack of proper knowledge on sexual and reproductive health, especially a low awareness and wrong use of different contraceptive methods in this population group is a call for concern.
Most of these girls know about the condom but use it improperly or, at the forefront, discourage its use because of the myths and misconception of its use. Apart from preventing unwanted pregnancies, the condom has the advantage of preventing sexually transmitted infections (STI).
Most of these girls are encouraged to engage into marriage at very tender ages. In such communities where, early marriages are encouraged such as the Oku community, the rate of adolescent pregnancy is bound to be high.
In fact, in a study carried out by Tebeu in 2006, in Maroua, Cameroon, showed a high prevalence of adolescent pregnancy of 26.5%; Maroua is one of the towns in Cameroon where early marriages are promoted.
Most of these girls have little or no say when it comes to their reproductive and sexual health. The few who have a knowledge on contraceptive use are prohibited from discussing such topics as it is looked upon as a taboo.
Also, poverty has an important role to play when it comes to adolescent pregnancies, especially in this community. The parents of most of these girls find it difficult to sponsor them through secondary school because they are unable to afford the tuition, textbooks and other school necessities.
At the end of the day they become school dropouts. For their up keep most of them engaged in sexual relations with other adolescents or adults in exchange for a few coins; and with a poor knowledge on contraception, they end up pregnant or contracting sexually transmitted infections. This appends a burden to the girl, her parents and the global economy.
Furthermore, the advice of the parents of these girls, most of whom were once teenage parents, against engaging in sexual relations at an early age is constantly been kicked upstairs as they are reminded by these girls how they gave birth to them when they were teenagers. Being a teenage parent in the past gives these parents limited control over their teenage daughters, consequently resulting in an unwanted teenage pregnancy.
Lastly, some of these girls find pride among their friends to have a child with a particular elderly male, married or not. All the aforementioned reasons explain to a greater extend why adolescent pregnancy is common in this community.
Consequently, as adolescent mothers they are more likely to: discontinue schooling, become under or unqualified, be unemployed or lowly paid and finally, live in poverty. Being unemployed or underpaid, they are incapable of providing for their children. So the children of these adolescent mothers grow in poverty; become bastards; perform poorly in school; easily agree to the idea of early marriages and then become teenage parents themselves; and the cycle starts all over again.
This could go a long way to explain why Cameroon did not achieve the targets of the Millennium Development Goals 1, 5 and 6 in 2015 (MDG report, Cameroon; 2015). Precisely, assessment of the progress of goals 1 and 5 were classified as being off track while goal 6 experienced regression in recent years.
Interventions to educate these girls, included the partners of already married adolescents, on sexual and reproductive health; increasing awareness and proper of different contraceptive methods, will go a long way to curb the high rate of adolescent pregnancy in this community.
Also, encouraging basic, secondary and college education by awarding scholarship to girls of these age group should be considered as a priority. The creation of vocational training centers, jobs, and scholarship programs which targets adolescent girls could be awarded to help these girls learn a trade and earn a living. These will reduce the rate of early marriages, instill financial independence, and with a proper education, the ability to take their futures into their own hands.
Finally, the activities mother and child care clinics should be reinforced in the respective health centers and hospitals this community. A trimestral outreach activity of this clinic to educate on sexual and reproductive health, with adolescents as their main target is imperative to impact the lives of these girls.
For these clinics to function smoothly, the government needs to organize training programs for health personnel running these clinics and ensure availability of the different contraceptive methods at affordable costs.
Adolescent pregnancy is very common in most rural communities and it poses a threat to the future of the youths. This is perpetuated by certain factors like lack of proper education on reproductive sexual health and poverty. These pregnancies are associated with increased maternal and infant morbidity and mortality. The couples (mother and child) end up in living abject poverty with little or no hope about the future. There is an urgent need to implement strict interventions throughout the national territory, especially in rural areas in order to curbs the high rates of adolescent pregnancy.
If nothing is done, Cameroon might not compass the objective of the sustainable development goals 1, 2, 3 and 4 come 2030.
This Post is a contribution of Valirie Ndip Agbor, M.D. Ibal sub-Divisional Hospital, Oku, Northwest Region,